How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $117.49 Median $3,548.13 Typical High $7,413.10 | Facility | None | $117.49 | $3,548.13 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $501.19 | Professional | None | $112.20 | $213.80 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $457.09 Typical High $457.09 | Professional | None | $213.80 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $371.54 | Professional | None | $125.89 | $223.87 | $371.54 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $229.09 Typical High $602.56 | Facility | None | $169.82 | $229.09 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $489.78 | Professional | None | $128.82 | $234.42 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $309.03 | Professional | None | $128.82 | $218.78 | $309.03 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $338.84 | Professional | None | $162.18 | $302.00 | $338.84 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $114.82 Median $218.78 Typical High $512.86 | Professional | None | $114.82 | $218.78 | $512.86 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $85.11 Typical High $120.23 | Professional | 52 · Reduced service | $56.23 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $34.67 Typical High $47.86 | Professional | 53 · Discontinued | $22.39 | $34.67 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $128.82 Typical High $177.83 | Professional | 54 · Surgery only | $85.11 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $25.70 Typical High $35.48 | Professional | 55 · Aftercare only | $16.98 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $16.98 Typical High $23.99 | Professional | 56 · Pre-op care only | $11.22 | $16.98 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $120.23 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $79.43 | $120.23 | $165.96 |
Where Georgia sits
The same service costs 3.5 times more in Alaska than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Georgia· 18th of 51
$224
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.